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PINNACLE TREATMENT CENTERS VA-I LLC NPI 1558874461


NPI Information

NPI: 1558874461
Provider Name: PINNACLE TREATMENT CENTERS VA-I, LLC

Doing Business As: FCCR SOUTHLAKE

Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

CLIA Number: 49D2138129

Address:
905 SOUTHLAKE BLVD
SUITES A & C
NORTH CHESTERFIELD, VA
ZIP 23236
Phone: (804) 354-1996
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PINNACLE TREATMENT CENTERS VA-I, LLC is a methadone clinic center in North Chesterfield, VA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. PINNACLE TREATMENT CENTERS VA-I, LLC NPI is 1558874461. The provider is registered as an organization entity type.
The provider Is Doing Business As Fccr Southlake.

The provider's business location address is:

905 SOUTHLAKE BLVD
SUITES A & C
NORTH CHESTERFIELD, VA
ZIP 23236-955
Phone: (804) 354-1996

The provider's authorized official is Robyn Tanis .
The authorized official title is Exec Dir Contract Management and has the following contact phone number (856) 533-8762.

The CLIA number assigned to this NPI record is 49D2138129 - other - alcohol & drug txt scvs with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/14/2017 and was last updated on 11/21/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthNo
2261QR0800XClinic/CenterRecovery CareNo
3261QM2800XClinic/CenterMethadoneYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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